Effective one lung ventilation (OLV) with the Fuji Systems product range

Isolate the lungs

Ventilate effectively

Deliver positive patient outcomes

Uniblocker™: an easy-to-direct torque control blocker for full lung or selective lobar blockade during OLVUnlike other bronchial blockers, the shaft of Uniblocker™ is made from wire mesh coated with polyurethane, ensuring that any manipulation is translated to the tip of the blocker in a 1:1 ratio.

Together with its fixed distal curve, the unique design of Uniblocker™ maximises control during insertion and facilitates blockade of the left or right bronchus through a standard single-lumen endotracheal tube.

Uniblocker™ is designed to:

Enable both full lung or selective lobar blockade during OLV1,2

Enable lung isolation even in patients with difficult airways or tracheostomies3

Facilitate easy removal without disconnection from the anaesthesia circuit1

Swivel connector

Swivel connector enables rotation of the circuit if the patient is moved and facilitates FOB insertion.

Quick release for easy removal

Uniblocker™ is easily removed without

disconnecting the swivel connector from the

anaesthesia circuit using the quick release connector.

Torque control blocker (TCB)

The Uniblocker™ shaft incorporates a metallic mesh which gives

torque control enabling smooth manipulation and ease of placement.

High volume gas barrier (GB) cuff

Soft high volume cuff made of silicone with GB properties to reduce diffusion of gas into or out of the cuff.

“The Fuji Uniblocker™ with stylet, which allows flexible high torque control and good controllability of the catheter tip, can be easily directed to block a selective lobar bronchus. The stylet can be removed, and a 1.4mm lumen can be used as a suction port for rapid deflation of lobes or for oxygen insufflation to apply continuous positive airway pressure to deflated lobes.”

Ichikawa J. et al., 2011

Uniblocker™ is an effective bronchial blocker that is particularly beneficial in establishing selective lobar blockade.

Selective lobar blockade avoids total lung collapse improving oxygenation, and avoiding difficulties associated with re-collapse of the lung2

Uniblocker™ can be inserted during surgery to initiate OLV and can be removed at the end of the procedure leaving the ETT in place if postoperative ventilatory support is required4

Bronchial blockers remain the ‘technique of choice’ in paediatric patients who are too small for double-lumen tubes5

Consider using Uniblocker™ for:

Already intubated patients requiring lung isolation6

Difficult airways6

Patients with limited mouth opening6

Nasotracheal intubation6

Awake orotracheal intubation6

Tracheostomy patients requiring lung isolation6

Selective lobar blockade6

Univent™: a versatile single-lumen ETT with an easy-to-direct TCB, for full lung or selective lobar blockadeUnivent™ is a single-lumen endotracheal tube with a small separate lumen containing a hollow non-latex bronchial blocker that can extend about 8-10cm beyond the tip.

Univent™ is designed to:

Block either the left or right lung to enable OLV or can be used for selective lobar blockade7

Enable lung isolation even in patients with difficult airways or tracheostomies3

Enable the tube to remain in place without the need for tube exchange in patients who require airway management after thoracic surgery8

Small, non-latex blocker

Hollow non-latex blocker with a soft, flexible tip for patient comfort.

Flexible blocker shaft

Malleable shaft with high torque control for smooth intubation into the target bronchus.

High volume, low pressure tracheal cuff

Tracheal cuff is coloured blue to help visualise the cuff during positioning.

“In patients with a recognized and/or unrecognized difficult airway, placement of a DLT with direct laryngoscopy can be extremely difficult and at times, impossible.”

“In this situation, placement of a single-lumen ETT is easier and often necessary, requiring the need for a bronchial blocker for subsequent lung isolation.”

Miller H.J., 2003

When a double-lumen device isn’t indicated, Univent™ can deliver the following benefits:

Simple initial insertion3

Nasotracheal placement3

Isolation and selective inflation or deflation of either right or left lung and selective lobar blockade7

Continuous positive airway pressure (CPAP) if needed due to the hollow blocker3,8

High-frequency jet ventilation in certain procedures3

Postoperative ventilation without the need for a tube change at the conclusion of surgery, reducing the risk of airway loss3,8

Consider using Univent™ for:

Upper airway abnormalities/tracheostomy patients requiring lung isolation – the smaller sized Univent™ devices can be passed through the narrowed upper airway or tracheostomy of these patients9

Selective lobar blockade9

Nasotracheal intubation6

Peripheral bronchopleural fistula in a stable patient9

Non-pulmonary thoracic surgery9

Bronchial surgery9

Silbroncho™: a silicone double-lumen endotracheal tube (ETT) for OLV, designed with patient comfort in mindSilbroncho™ is a 100% silicone, double-lumen ETT with a soft, flexible, wire-reinforced tip and narrow bronchial cuff.

Silbroncho™ is designed to:

Deliver the flexibility required to overcome difficulties associated with endobronchial intubation of acutely-angled left-stem bronchi10

Achieve a depth of placement that can reduce the risk of displacement vs equivalent sized PVC tubes11,12

Reduce the risk of trauma during intubation with its soft silicone tip

Soft, flexible tip

Facilitates endobronchial intubation and reduces the risk of trauma

during intubation.

Wire-reinforced bronchial tip

Wire-reinforcement to prevent bronchial lumen compression when the patient is in the lateral position13, to reduce the incidence of kinking and to assist X-ray verification.

100% silicone

Designed to maximise patient comfort.

Resistant cuff

Silicone cuff designed to resist puncture and tearing by teeth.

Narrow bronchial cuff

Narrow bronchial cuff to reduce the chance of upper-lobe obstruction.13

“For one-lung ventilation in many surgical cases, double-lumen endotracheal tubes are the first-line choice for airway management.”

Yaney L.L., 2007

“The D-shaped wire-reinforced lumen maintains the tip at a 45-degree angle. The reinforced wall tends to prevent obstruction or kinking of the bronchial lumen, yet at the same time maintains flexibility. It is especially useful if the left main stem bronchus is angled at 90 degrees from the trachea, making it almost impossible to position a PVC DLT.”

Barash P.G. et al., 2005

Silbroncho™ is intended for the airway management of surgical patients to perform one-lung ventilation:

Double-lumen endotracheal tubes remain the gold-standard for most OLV procedures14

Selective collapse of the operated lung can improve operative conditions and thus reduce the duration of surgery13

Only a double-lumen tube can be used to control the distribution of ventilation to either or both lungs during a surgical procedure13

Unlike PVC tubes, the silicone Silbroncho™ offers greater flexibility for improved access to acutely-angled left-stem bronchi10

Consider Silbroncho™ for use in:

Elective pulmonary resection, right-sided9,15

Video-assisted thoracoscopic surgery (VATS) 9,15

Lobectomy9

Thoracoscopy9

Left pneumonectomy9

Pulmonary haemorrhage9

Large central bronchopleural fistula / urgent situations (awake intubation with FOB)9

Unilateral lung lavage9

Independent lung ventilation9,15

Fuji WRETT: a long wire-reinforced endotracheal/endobronchial tube designed to seal either the trachea or mainstem bronchusThe Fuji WRETT is 40 cm in length – 8cm longer than a standard WRETT – and is designed to seal either the trachea or the mainstem bronchus during tracheal or bronchial resection.

The Fuji WRETT is designed to:

Maximise patient comfort: the tube is made from medical grade silicone rubber and stainless steel with a smooth tip to minimise the risk of tracheal damage

Maximise stability with its wire-reinforced flexible tube. This can be important when moving a patient or during head and neck surgery

Enable the tube to be advanced into the bronchus and withdrawn into the trachea as needed during surgery under fiberoptic bronchoscopic guidance

Silicone for patient comfort

Medical grade silicone rubber and stainless steel utilised to maximise patient comfort.

Long length (40cm), wire-reinforced tube

Wire reinforcement is designed to reduce the risk of kinking or compression under manipulation or warmth.

Short cuff without a Murphy eye

The short cuff of the tube can be inflated to provide a seal in either the trachea or mainstem bronchus.

“The ideal endotracheal tube for tracheal reconstruction has been described as a long, flexible, reinforced tube with a short, low-pressure, high-volume cuff and a short segment beyond the cuff to allow the ventilation of both lungs through a short, tracheal stump without encroachment on the operative site.”

Slinger P.D., 2011.

“Some surgeons prefer single-lumen endobronchial tubes to DLTs for procedures involving the carina since they are more flexible, permitting better mobilization and exposure.”

Slinger P.D., 2001.

The Fuji WRETT is a viable option when the flexibility to seal either the trachea or the mainstem bronchus is required.

8cm longer than standard wire-reinforced ETT tubes to achieve adequate depth of placement

Easily inserted and placed using the flexible polyurethane stylet

Short, narrow cuff placed right at the tip of the device to enable ventilation of both lungs while not advancing on the operative site during tracheal resection

Can be advanced into the bronchus and withdrawn into the trachea as required under fiberoptic bronchoscopic guidance

Consider using the Fuji WRETT for:

Tracheal and bronchial resections

Head and neck surgery

Sleeve pneumonectomy

Endobronchial placement during life-saving manoeuvres (airway haemorrhage, acute contralateral tension pneumothorax) where the lung must be isolated immediately5

Fuji Systems product usage guide

Uniblocker™ Univent™ Silbroncho™ Fuji WRETT

Paediatrics ✔ ✔ ✘ ✔

Difficult airways ✔ ✔ ✘ ✔

Tracheostomy patients ✔ ✔ ✘ ✔

Selective lobar blockade ✔ ✔ ✘ ✘

High-torque control blocker ✔ ✔ ✘ ✘

Facilitates postoperative ventilatory support without tube change ✔ ✔ ✘ ✔

Intranasal placement ✔ ✔ ✘ ✘

Suitable for use with standard single-lumen ET tubes ✔ ✘ ✘ ✔

Silicone for patient comfort ✘ ✔ ✔ ✔

Gold standard, double-lumen device ✘ ✘ ✔ ✘

Ability to control the distribution of ventilation to either or both lungs during surgery

✔ ✔ ✔ ✘

Independent suctioning of lungs possible ✘ ✘ ✔ ✘

Rapid lung deflation ✘ ✘ ✔ ✘

Fuji Systems product specifications

Uniblocker™

Product Code Description O.D. (mm) Length (mm) Effective Length* (mm) Maximum Cuff Volume (ml)

1203104 Uniblocker™, small 1.7 (5.0 Fr) 460 415 3

1203105 Uniblocker™, adult 3.0 (9.0 Fr) 665 510 8

Univent™

Product Code Description I.D. (mm)O.D. (mm) (Approximate Value)

Maximum Inflation Volume (Main Cuff) (ml)

Maximum Inflation Volume (Blocker Cuff) (ml)

1202716 Univent™, paediatric without cuff 3.5 7.5/8.0 N/A 3

1202720 Univent™, paediatric with cuff 4.5 8.5/9.0 15 3

1202627

Univent™, adult sizes

6.0 9.7/11.5 40 6

1202628 6.5 10.2/12.0 40 6

1202630 7.0 10.7/12.5 40 6

1202631 7.5 11.2/13.0 50 6

1202633 8.0 11.7/13.5 50 6

1202635 8.5 12.2/14.0 50 6

1202636 9.0 12.7/14.5 50 6

Silbroncho™

Product Code Size I.D. (mm) O.D. (mm)

1203533 33 Fr, left 4.1/6.5 9.5/12.3

1203535 35 Fr, left 4.5/7.0 10.0/13.3

1203537 37 Fr, left 4.9/7.5 10.5/14.3

1203539 39 Fr, left 5.3/8.0 11.0/15.3

Fuji Long WRETT

Product Code Size I.D. (mm) O.D. (mm)

1200824 24 Fr 5.5 8.0

1200828 28 Fr 6.5 9.4

1200831 31 Fr 7.5 10.4 *The effective length is the longest value from the tip to the airway joint with the swivel connector.

Find out more about the Fuji Systems range

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FUJI

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Distributed by:

Authorised EU Representative: KRAUTH medical KG (GmbH & Co.) Wandsberker Konigstr. 27-29, D-22041 Hamburg, Germany

Manufactured by: Fuji Systems Corporation 200-2 Aza Ohira, Odakura, Nishigo, Nishi Shirakawa-gun, Fukushima Ken 961-8061 Japan

Read InstRuctIons BefoRe use

Copyright © 2012 The Laryngeal Mask Company Limited, LMA, LMA Better by Design are trademarks of the LMA Group of Companies. The Uniblocker, Univent and Silbroncho logos and their component parts are trademarks of the Fuji Systems Corporation, manufacturers of the Uniblocker, Univent and Silbroncho products.

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References:

1. Fuji Uniblocker™ Instructions For Use, March 2012.

2. Ichikawa J. et al. Anesthe Clinic Res 2011; 2 (7). URL: http://dx.doi.org/10.4172/2155-6148.1000150.

3. Miller H.J. Denver Health Medical Center/University of Colorado Health Sciences Center, 2003.

4. Slinger P.D. Principles and Practice of Anesthesia for Thoracic Surgery. Springer, 2011 edition.

5. Brodsky J.B. BJA 2009; 103 (BJA/PGA Supplement): i66-i75 doi:10.1093/bja/aep262.

6. Campos J.H. Conferencias Magistrales 2011; 34 (Supl. 1): S270-S277.

7. Fuji Univent™ Instructions For Use, October 2011.

8. Doyle J.D. The Difficult Airway II 1995; 13 (3): 495-511.

9. Slinger P.D. Lung Isolation Techniques, 1997. URL: http://www.anesthesia.org/winterlude/wl97/W_LungIsolation.html

10. Barash P.G. et al. Clinical Anesthesia. Lippincott Williams and Wilkins; 5th Revised edition (1 Sep 2005).

11. Lohser J., Brodsky J.B. J Cardiothorac Vasc Anesth 2006; 20 (1): 129-131.

12. Lee J.S. et al. Korean J Anesthesiol 2005; 48 (5): 509-513.

13. Brodsky J.B, Lemmens H. J. M. Minerva Anestesiologica 2007; 73 (10): 513-524.

14. Yaney L.L. AANA Journal 2007; 75 (6): 411-415.

15. Fuji Silbroncho™ Instructions For Use, October 2011.

16. Slinger P.D. CJA 2001; 48 (6): R1-R10.